MHQP Receives BCBSMA Foundation Grant to Explore Asian Patient Experiences
Through a Special Initiatives grant from the Blue Cross Blue Shield of Massachusetts Foundation (BCBSMAF), MHQP has launched a new project designed to help better understand why Asian patients report worse experiences with primary care than other racial populations. A deeper understanding requires a more nuanced consideration of the unique cultures and primary care preferences of the Asian sub-populations commonly grouped together in research.
An analysis of data collected in MHQP’s 2022 annual statewide Patient Experience Survey of commercially-insured patients showed that:
- On the question that asks patients if they were able to get an appointment for a check-up or routine care as soon as they needed, Asian patients reported scores that were 9.4 points lower than White patients and 7.5 points lower than Black patients.
- On the question that asks patients if, during their most recent visit, anyone in the provider’s office asked about medications they were taking, Asian patients reported scores that were 5.6 points below White patients and 0.3 points below Black patients.
- On the question that asks patients if they completely trust their provider’s decisions about which medical treatments are best for them, Asian patients reported scores that were 4.2 points lower than White patients and 0.8 points lower than Black patients.
These disparities are similar to those identified in national research. There is no clear explanation for why these disparities exist. Many studies have suggested the reason may relate to “rating tendencies” and other “cultural” explanations (1). This explanation may be inadequate, however, especially since the “Asian” category includes several distinct sub-populations, each with their own cultures and languages.
As part of MHQP’s larger initiative to understand and reduce racial and ethnic disparities in patient experiences of primary care, this project will explore drivers of patient experiences among three sub-populations which collectively account for 74% of the Asian population in Massachusetts: Chinese (38%), Indian (26%) and Vietnamese (10%).
We hope to answer important questions such as:
- Why do Asian patients rate their primary care experiences lower than other racial populations and do these ratings differ by Asian sub-population?
- What are Asian patient experiences of primary care and do these differ by sub-population?
- What factors are important to Asian patients when choosing or continuing to see a primary care provider and are there differences in factors by Asian sub-population?
To support the work, MHQP is partnering with a Community Action Board consisting of community leaders from the Chinese, Indian and Vietnamese communities in Massachusetts who are active in advocacy and healthcare. The Community Action Board, which co-developed this project, will help MHQP recruit patients for structured interviews from these sub-populations and will provide guidance in analyzing the resulting data. From this information, MHQP will develop a conceptual framework of factors that influence Asian patient experiences of primary care and draft a report with proposed recommendations to improve Asian sub-population patient care experiences.
“We have been seeing disparities in patient experiences for Asian patients for a long time, yet the research has not been conducted to fully understand why these disparities exist,” said MHQP President and CEO Barbra Rabson. “This project will help us better understand the experiences and expectations of Asian patients and will be an important step to improving the experiences of all patients. We are grateful to BCBSMAF for funding this important work.”
“The Blue Cross Blue Shield of Massachusetts Foundation’s Special Initiatives Grant program is designed to empower communities to advance health equity identified at the community level and the partnership between MHQP and the Community Action Board holds great promise to drive the health care sector to improve its delivery of culturally responsive care,” said Audrey Shelto, BCBSMAF President and CEO. “There are many disparities that we don’t understand well because of a lack of inquiry and this research project can bring consumer voice to the conversation about health care quality.”
“Studies show that Asian Americans are less likely to be satisfied with their care and less likely to trust their doctor than patients of other racial groups,” said Chien-Chi Huang, founder and Executive Director of Asian Women for Health and a member of the Community Action Board. “This study will provide much needed insights to help improve care delivery and health outcomes for the Asian population.”
- Saha, S., & Hickam, D. H. (2003). Explaining low ratings of patient satisfaction among Asian-Americans. American Journal of Medical Quality, 18(6), 256–264. https://doi.org/10.1177/106286060301800606